Evaluation of a theory-informed implementation of a nursing discharge teaching intervention for older adults

Abstract

Aims: To evaluate the implementation process of a multi-site trial of a novel discharge teaching intervention. Design: Hybrid type 3 trial. Methods: A discharge teaching intervention for older adults was implemented in medical units from August 2020 to August 2021 with 30 nurse participants. The implementation process was guided by behaviour change frameworks. Outcome data comprised determinants of nurses' behaviours related to teaching and the acceptability, appropriateness, feasibility of the intervention and frequency of teaching activities received by the participants. This study adheres to StaRI and TIDieR reporting guidelines. Results: Twelve of 18 determinants of nurses' behaviour domains improved post-implementation. Being trained reinforced nurses' knowledge and skills in patient teaching. Practicing the intervention increased their awareness on the gaps between evidence-based teaching principles and their actual practice. The intervention was considered acceptable and moderately appropriate and feasible. Conclusion: A theoretically informed implementation process can influence nurses' perceptions and behaviours related to discharge teaching by targeting specific behaviour domains. Practice change to improve discharge teaching will require organizational support from nursing management. No Patient or Public Contribution: Although the conceptual foundations of the intervention tested in this study were informed by the priorities and experience of patients, this population was not directly involved in the design and conduct of the study. Trial registration: ClinicalTrials.gov: NCT04253665.